(Philadelphia, PA) -- Obesity continues to plague an ever-growing number
of Americans, dramatically increasing not only their girth, but also their
chances of developing Type 2 Diabetes, heart disease and other debilitating
illnesses. The situation is further complicated when those seeking to
lose weight generally have only glossy advertisements or testimonials
to guide them to an appropriate source of help. To address this problem,
researchers at the University of Pennsylvania School of Medicine
have evaluated major commercial diets and self-help weight loss programs,
providing physicians and their overweight patients with the first comprehensive
review of these resources. The article will appear in the January 3, 2005
issue of the Annals of Internal Medicine.

Adam Gilden Tsai, MD and Thomas A. Wadden, PhD,
examined four types of programs: non medical, medically supervised, Internet-based,
and organized self-help (e.g. Overeaters Anonymous). For each of the largest
nationally based programs in these categories, the authors described the
principal treatment components, staff qualifications, and costs (as determined
from company websites and discussions with program representatives). The
average weight loss for each program was determined by reviewing scientifically
acceptable studies. The review examined only programs that required regular
in-person or on-line contact.

“Our principal goal was to give health care providers sound information
about the many weight loss programs available so they can advise their
overweight patients,” said Dr. Tsai, Instructor of Medicine with
the University’s Weight and Eating Disorders Program. “Physicians
in busy primary care practices frequently do not have the time or training
to provide needed weight loss counseling. We hope this review will serve
to inform them of options in their community.”

Among non-medical commercial programs (including Weight Watchers, Jenny
Craig, and LA Weight Loss), the authors found that Weight Watchers was
the most thoroughly tested. Participants in two studies lost approximately
5% of their initial weight (about 10 pounds) in three to six months. Attending
Weight Watchers group meetings weekly for three months was estimated to
cost $167. The costs for Jenny Craig and LA Weight Loss were substantially
higher, and no scientifically acceptable evaluations of weight loss have
been published.

Medically supervised plans, including Health Management Resources (HMR)
and OPTIFAST, produced average losses of 15% - 25% of initial weight (about
30-50 pounds) in three to six months. These plans, which include the use
of a liquid diet to replace all or most foods eaten, were estimated to
cost $1700 - $2200 for the first three months. (This covered all medical
care, group lifestyle counseling, and the liquid diet). “This approach
may be appropriate for persons who have significant obesity-related health
complications such as Type 2 Diabetes or hypertension,” commented
Dr. Wadden, Director of Penn’s Weight and Eating Disorders Program.
Enthusiasm, however, for this approach is limited by findings that people
regain approximately 50% of lost weight one to two years after treatment.
“Weight regain is a problem following all weight loss efforts, but
particularly after this regimen,” Wadden noted.

The review revealed minimal scientific evidence to support the use of
a new generation of Internet-based weight loss plans. “But we know
additional studies are being conducted and, if found effective, the Internet
could provide weight management to millions of Americans,” Tsai
explained. Similarly there has been little evaluation of self-help programs,
including Overeaters Anonymous and Take Off Pounds Sensibly (TOPS), that
charge minimal or no fees. “Despite the lack of documented effectiveness,
organized self-help approaches are an important option for persons who
cannot afford commercial programs,” said Wadden.

The authors stated that all of the programs reviewed had undoubtedly been
of help to some individuals. They hope their review will encourage health
care providers and their patients to start talking about excess weight,
even if commercial or self-help programs are not an option.

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PENN Medicine is a $2.7 billion enterprise dedicated
to the related missions of medical education, biomedical research, and
high-quality patient care. PENN Medicine consists of the University of
Pennsylvania School of Medicine (founded in 1765 as the nation’s
first medical school) and the University of Pennsylvania Health System
(created in 1993 as the nation’s first integrated academic health
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Penn’s School of Medicine is ranked #3 in the nation for receipt
of NIH research funds; and ranked #4 in the nation in U.S. News &
World Report’s most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students, the School
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